Basic Information
| Provider Information | |||||||||
| NPI: | 1629394234 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZEITGEIST WELLNESS GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1222 N MAIN AVE | ||||||||
| Address2: | 740 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782125712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102717411 | ||||||||
| FaxNumber: | 2102719414 | ||||||||
| Practice Location | |||||||||
| Address1: | 6501 BOEING DR. | ||||||||
| Address2: | J-1B | ||||||||
| City: | EL PASO | ||||||||
| State: | TEXAS | ||||||||
| PostalCode: | 79925 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 9158811333 | ||||||||
| FaxNumber: | 9158811358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2010 | ||||||||
| LastUpdateDate: | 04/08/2010 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PHD, LMFT | ||||||||
| AuthorizedOfficialTelephone: | 2102717411 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 51758 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.